Post-operative Intravenous Iron to Treat Iron-deficiency Anemia in Patients Undergoing Cardiac Surgery (POAM)
Post-operative Intravenous Iron to Treat Iron-deficiency Anemia in Patients Undergoing Cardiac Surgery: A Pilot, Multi-centre, Placebo-controlled Randomized Trial.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Keyvan Karkouti, MD
- Phone Number: 8597 416-340-4800
- Email: Keyvan.Karkouti@uhn.ca
Study Contact Backup
- Name: Deep Grewal
- Phone Number: 4221 416-340-4800
- Email: deep.grewal@uhn.ca
Study Locations
-
-
Ontario
-
Kingston, Ontario, Canada, K7L 3N6
- Recruiting
- Kingston Health Sciences Centre
-
Contact:
- Jeannie Callum, MD BA FRCPC
- Phone Number: 74897 613-533-6000
- Email: Jeannie.Callum@kingstonhsc.ca
-
Toronto, Ontario, Canada, M4N 3M5
- Recruiting
- Sunnybrook Health Sciences Centre
-
Contact:
- Yulia Lin, MD FRCPC
- Phone Number: (416) 480-4042
- Email: Yulia.Lin@sunnybrook.ca
-
Toronto, Ontario, Canada, M5G 2C4
- Recruiting
- Toronto General Hospital - University Health Network
-
Contact:
- Justyna Bartoszko, MD MSc FRCPC
- Phone Number: 3243 416-340-4800
- Email: justyna.bartoszko@uhn.ca
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Patients who are undergoing any non-emergency open cardiac surgery and who meet all following criteria:
- Age greater than 18 years old
Preoperative iron-deficiency with or without anemia (defined as Hb <130 g/L) with any one of:
- ferritin ≤100 μg/l; or
- ferritin ≤ 300 μg/L and transferrin saturation ≤ 20%; or
- reticulocyte Hb content < 29 pg, where available
Exclusion Criteria:
Patients who meet any of the following criteria are not eligible for the study:
- specialized procedures (e.g., ventricular assist device insertion, thoracoabdominal aneurysm, complex adult congenital surgery and heart transplant)
established contraindications to IV iron:
- hypersensitivity to the iron product
- history of >2 food and/or drug allergic reactions (excluding drug intolerance)
- non-iron deficiency anemias such as myelodysplastic syndrome
- history of iron overload or disturbances in use of iron such as hemochromatosis or hemosiderosis
- decompensated liver cirrhosis (MELD ≥ 19) or active hepatitis
- active infection
- preoperative unstable hemodynamics defined as the requirement for vasopressors or inotropes, or active bleeding (as noted in the clinical record and/or defined as a requirement for red blood cell transfusion for ongoing clinical bleeding)
- refusal of blood products for religious or other reasons
- known pregnancy
- already enrolled in this trial
- enrolment in another interventional trial which may impact anemia or transfusion management (for example, a trial of hemostatic therapies, such as tranexamic acid)
- receipt of intravenous iron at any point in the 6 weeks prior to randomization
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Intervention Group
Patients randomized to the IV iron group will receive 1000 mg ferric derisomaltose (Monoferric) diluted in 100 mL of 0.9 % sodium chloride solution, via intravenous infusion over 1 hour using an opaque IV bag and tubing for blinding.
|
Ferric derisomaltose will be prepared by an unblinded research pharmacist/delegated staff as per standard of care procedures.
Specifically, 10 mL (containing 1000 mg ferric derisomaltose) will be diluted in 100 mL of sterile 0.9% sodium chloride solution and drawn up into blinded syringes and tubing.
The 1000 mg doses of ferric derisomaltose will be administered by a bedside nurse over 60 minutes via an infusion pump through a dedicated IV.
Other Names:
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Placebo Comparator: Control group
Patients randomized to the placebo group will receive 100 mL of 0.9 % sodium chloride solution via intravenous infusion using an opaque IV bag and tubing for blinding.
|
Patients in the control group will receive placebo, which will be 100 mL of sterile 0.9% sodium chloride solution and drawn up into blinded syringes and tubing according to good manufacturing practice (GMP).
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Feasibility Outcome 1: Percentage of major protocol deviations
Time Frame: through study completion, an average of 1 year.
|
Percentage of major protocol deviations with a feasibility threshold of ≤ 5% (i.e., treatment not according to randomization allocation or dosing schedule; treatment initiated in ineligible patients or outside of allotted periods)
|
through study completion, an average of 1 year.
|
|
Feasibility Outcome 2: Adequate patient enrollment
Time Frame: through study completion, an average of 1 year.
|
Adequate patient enrollment defined as ≥20% of eligible patients enrolled.
|
through study completion, an average of 1 year.
|
|
Feasibility Outcome 3: Percentage of patients lost to follow-up at 90 days
Time Frame: through study completion, an average of 1 year.
|
Percentage of patients lost to follow-up at 90 days with a feasibility threshold of ≤ 5%.
|
through study completion, an average of 1 year.
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Justyna Bartoszko, MD, University Health Network, Toronto
- Principal Investigator: Yulia Lin, MD, Sunnybrook Health Sciences Centre
- Principal Investigator: Jeannie Callum, MD, Kingston Health Sciences Centre
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Nutrition Disorders
- Metabolic Diseases
- Hematologic Diseases
- Iron Metabolism Disorders
- Anemia, Hypochromic
- Malnutrition
- Iron Deficiencies
- Anemia
- Anemia, Iron-Deficiency
- Deficiency Diseases
- Inorganic Chemicals
- Chlorine Compounds
- Sodium Compounds
- Chlorides
- Hydrochloric Acid
- ferric derisomaltose
- Sodium Chloride
Other Study ID Numbers
Other Study ID Numbers
- 22-5685
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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